The changing oral health status of older adults has focused attention on the need to broaden oral health promotion and prevention activities for this group. The Oral Health Working Group of the US Surgeon General's Workshop: Health Promotion and Aging recently reported that more activities are needed in education and service for older adults--areas that fall within the purview of state and local health agencies. Although dental public health programs for older adults have received more attention, the current breadth and variety of state dental health activities for older adults is unknown. This telephone survey of state dental health departments found that among the 10 states with the largest older adult populations, five were providing oral health programs for the elderly. The 30 states reporting the existence of oral health programs for the elderly account for 58 percent of the total US elderly population. Oral health activities were quite varied, with the majority of states focusing on institutionalized patients and their care givers. Respondents reported that access to dental consultants with gerontological training and information on model oral health programs for older adults would assist program development. Public health agencies play a significant role in improving the quality of life for the nation's elderly. Dental public health programs clearly have demonstrated the ability to improve health prevention and health promotion among younger populations. It is crucial to utilize these skills to begin to enhance the oral health and quality of life of older adults, as well.